Since this is a depression site, I can safely assume most of us here have experienced cognitive behavioral therapy (CBT). Accordingly, I am not going to presume to write a piece about what you already know. Instead, I am seeking your wisdom. Let’s get started.
Okay, here’s the deal, as set out in an article of mine on mcmanweb:
You're stuck in traffic. But now, instead of you thinking that your day is ruined, you see this as a situation that never should have happened had there been no such thing as Fox News (or white Zinfandel, for that matter), this in a culture that gave us Louis Armstrong and Saran Wrap. What has gone wrong with the world? you can only wonder, midway between your cubicle at work and the soccer game you're supposed to be driving your kids to, and your husband doesn't give a crap, and, well, there's gotta more to life than this ...
Cognitive therapy teaches us to pick up the distortions in our thinking as they occur - to become a detached observer - and to substitute these destructive thoughts with more constructive thinking. In effect, we are turning “It’s the end of the world” into “Let’s come up with a solution,” or, if not a solution, a sense of acceptance.
There may be nothing we can do about being stuck in traffic, for instance. But perhaps we can enjoy the opportunity to turn up the radio real loud and listen to uninterrupted Mahler for the next 45 minutes. How does it FEEL listening to uninterrupted Mahler? A lot better than fretting about how unfair life is, thank you very much.
That’s the theory. Putting CBT into practice when you are fending off a fierce depression, however, can be rather problematic. Perversely, we are introduced to CBT when we are least equipped to put it into practice. The therapy (typically 8 to 12 sessions), nevertheless, is sold as a way of relieving depression. Clinical trials typically round up a bunch of depressed people and measure their depressions (say with the HAM-D), give half the subjects CBT, do whatever with the other half, then compare HAM-Ds at the end. Typically, the CBT group shows a significantly greater improvement than the whatever group.
These studies may check in after six months for any sign of relapse (typically, those who took CBT are more resilient), but that’s the end of the story.
What is far more interesting to me is how we can incorporate the lessons we learned from CBT into our daily lives, to prevent depressions before they occur, or, at least, blunt their awful effect. I have always regarded CBT as a form of applied mindfulness - the mind watching the mind. According to Jon Kabat-Zin et al in The Mindful Way Through Depression: “Mindfulness, is the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to things as they are,” rather than as we want them to be.
Once we get mindfulness working for us, we can gradually start changing our software, to the point where constructive (and more optimistic) thinking becomes habitual. This is the beauty of the brain. It is plastic. It physically responds to learning. With practice, we learn to deal with our stuck-in-traffic situations.
But life has a way of throwing new challenges at us. Depression doesn’t exactly take a day off. Even when we are feeling well, we need to be vigilant. We need to catch our brains before they take us over the cliff, before that sickening crash. Or, in the event of an impending crash, we need to work on a soft landing. In essence, CBT - like all our recovery tools - is a daily practice and a lifetime commitment.
Here’s where you come in: I want to learn more, and you - the ones with lived experience - are the only ones who can help me. So why don’t I fire off some questions:
- How were you introduced to CBT?
- Did CBT help you get out of your initial depression?
- Did you continue to apply CBT in your daily life?
- What problems, if any, did you find in applying CBT?
- Did you develop related skills (such as mindfulness) which you applied to your daily life?
- Do you find CBT (or related skills) helpful in preventing (or easing) depression?
- Is your life better right now because of CBT?
Answer as many or few questions as you like. Add your own insights. Be brief or write a book. Trust me, your wisdom and insight matters. As always, you are the true experts. Comments below ...
Published On: May 30, 2013